Original article

Clinical analysis of bowel resection surgery for intestinal metastasis of ovarian cancer: a report of 65 cases

  • TANG Xiaojian ,
  • FENG Weiwei
Expand
  • Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2026-02-28

  Online published: 2026-06-23

Abstract

Objective To investigate the impact of depth of bowel wall invasion on clinical characteristics and prognosis in ovarian cancer patients with intestinal metastasis undergoing bowel resection. Methods A retrospective analysis was conducted on 65 patients with epithelial ovarian cancer who underwent cytoreductive surgery combined with bowel resection at Shanghai Ruijin Hospital from October 2013 to March 2025. Patients were divided into two groups according to the depth of bowel wall invasion: the serosa/muscularis invasion group (n=47) and the mucosa/submucosa invasion group (n=18). Clinicopathological characteristics and progression-free survival (PFS) were compared between the two groups. Results The median PFS was significantly longer in the mucosa/submucosa invasion group than in the serosa/muscularis invasion group (51.6 months vs. 27.2 months, P=0.014). Compared with the serosa/muscularis invasion group, the mucosa/submucosa invasion group had lower serum CA125 levels at initial diagnosis (300.5 U/mL vs. 1 050.0 U/mL, P=0.034), a higher rate of preoperative imaging detection of intestinal metastasis (100% vs. 48.9%, P<0.001), a lower proportion of patients with massive ascites at initial diagnosis (11.1% vs. 48.9%, P=0.005), and the intraoperative peritoneal cancer index (PCI) was also lower (8.7±4.6 vs. 13.4±6.5, P=0.007). No statistically significant differences were observed between the two groups in terms of surgery-related indicators and perioperative complications (all P>0.05). Conclusions In patients with ovarian cancer intestinal metastasis undergoing bowel resection, depth of bowel wall invasion is closely associated with prognosis. Those with invasion reaching the mucosa/submucosa have better prognosis and a relatively weak ability for abdominopelvic seeding. Thus, precise preoperative assessment of invasion depth may help optimize surgical strategies.

Cite this article

TANG Xiaojian , FENG Weiwei . Clinical analysis of bowel resection surgery for intestinal metastasis of ovarian cancer: a report of 65 cases[J]. Journal of Surgery Concepts & Practice, 2026 , 31(02) : 144 -148 . DOI: 10.16139/j.1007-9610.2026.02.08

References

[1] SCOTT C L, BANERJEE S, JOLY F, et al. Ovarian cancer[J]. Nat Rev Dis Primers, 2026,12:10.
[2] SIEGEL R L, KRATZER T B, WAGLE N S, et al. Cancer statistics, 2026[J]. CA Cancer J Clin, 2026, 76(1):e70043.
[3] CARUSO G, WEROH A S J, CLIBY W. Surgical management of advanced ovarian cancer[J]. JAMA, 2025, 334(14):1278-1291.
[4] CHANG S J, BRISTOW R E, CHI D S, et al. Role of aggressive surgical cytoreduction in advanced ovarian cancer[J]. J Gynecol Oncol, 2015, 26(4):336-342.
[5] SEHOULI J, GRABOWSKI J P. Surgery in recurrent ovarian cancer[J]. Cancer, 2019, 125(suppl 24):4598-4601.
[6] VITO ANDREA C, UCCELLA S, SOZZI G, et al. Primary site disease and recurrence location in ovarian cancer patients undergoing primary debulking surgery vs. interval debulking surgery[J]. Eur J Surg Oncol, 2021, 47(5):1075-1082.
[7] 孔聪聪. 卵巢恶性肿瘤肠道转移相关处理[J]. 中国计划生育和妇产科, 2018, 10(9):20-23.
  KONG C C. Management of intestinal metastases in ovarian malignancies[J]. Chin J Fam Plann Gynecotokology, 2018, 10(9):20-23.
[8] 张师前, 智绪亭, 刘乃富, 等. 卵巢癌肠道转移64例临床分析[J]. 中国现代普通外科进展, 2006, 9(2):110-112.
  ZHANG S Q, ZHI X T, LIU N F, et al. Intestinal metastasis of ovarian cancer: clinical analysis of 64 cases[J]. Chin J Curr Adv Gen Surg, 2006, 9(2):110-112.
[9] PLOTTI F, MONTERA R, ALOISI A, et al. Total rectosigmoidectomy versus partial rectal resection in primary debulking surgery for advanced ovarian cancer[J]. Eur J Surg Oncol, 2016, 42(3):383-390.
[10] IMTERAT M, GEBERS G, HEITZ F, et al. Low anterior resection syndrome and its impact on quality of life of ovarian carcinoma patients: a prospective longitudinal study[J]. Gynecol Oncol, 2023,178:96-101.
[11] YE S, WANG Y, CHEN L, et al. The surgical outcomes and perioperative complications of bowel resection as part of debulking surgery of advanced ovarian cancer patients[J]. BMC Surg, 2022, 22(1):81.
[12] MUALLEM M Z, SEHOULI J, RICHTER R, et al. Pre-operative serum CA125, peritoneal cancer index and intra-operative mapping score as predictors of surgical results in primary epithelial ovarian cancer[J]. Int J Gynecol Cancer, 2020, 30(1):62-66.
[13] QUAN Q, ZHOU S, LIU Y, et al. Relationship between ascites volume and clinical outcomes in epithelial ovarian cancer[J]. J Obstet Gynaecol Res, 2021, 47(4):1527-1535.
[14] LóPEZ-HERNáNDEZ F J, GONZáLEZ-GIL A, TORROBA A, et al. Peritoneal cancer index in ovarian cancer: what does the surgeon really see?[J]. Clin Transl Oncol, 2025, 27(11):4185-4191.
Outlines

/